Emergency Crisis Services for Psychiatric Boarder Patients at Central Vermont Hospital ED

Purpose: This project’s aim was to reduce the length of emergency department (ED) stays for psychiatric boarder patients at Central Vermont Medical Center (CVMC) and prevent unnecessary psychiatric inpatient admissions through access to psychiatric crisis stabilization care. Methods: June of 2016, CVMC ED developed a unit called the Transitional Care Area (TCA). TCA staffing consisted of mental health workers and security staff. Training strategies were derived from national evidence-based psychiatric care emergency programs (i.e., Alameda Model), along with pertinent safety actions from The Joint Commission. Training modules focused on community social supports, behavioral crisis stabilization modalities, and development of crisis stabilization treatment plans. TCA committee was developed to promote awareness and willingness for change on TCA unit and address key issues while transitioning the TCA towards a clinical crisis stabilization treatment approach. Results: Periods of 8/1/2016-9/30/2016, and 8/1/2017-9/30/2017, respectfully 147 and 82 patients were admitted to the TCA. Out of these admissions, 44 (2016 period) and 39 (2017 period) patients were referred for intensive psychiatric treatment. The average length of stay (LOS) for these patients was 52.9 hours (2016 period) and 69.9 hours (2017 period). Questionnaire responses identified the need for expansion of the TCA to offer a more therapeutic environment (i.e., fresh air, windows, and therapeutic furniture and electronic technical supports (i.e., Reconnect Media Wall), increased the need for staffing including Peers, and expansion of nurses and APRN role in the TCA. Conclusions: TCA Committee was successful in promoting change and access of increase staffing resources and security were no longer considered direct patient care staff. This project suggests that crisis psychiatric stabilization care with adequate staffing, could be cost-effective, decrease psychiatric ED boarder’s LOS and need for inpatient care. The project also displays the potential of replication in other ED’s in Vermon

Über den Aufprall von Hochgeschwindigkeitstropfen auf trockene und benetzte Oberflächen

This thesis focuses on the high-speed impact of liquid drops on dry smooth surfaces and thin liquid films in the presence of a strong gas flow using experimental and numerical methods. A flywheel experiment was designed to study such challenging conditions by analyzing the impact with different drop diameters, velocities, liquids and gas mixtures. A sophisticated algorithm was also developed for image analysis and to handle a large number of experimental data. Selected experimental cases were complemented with numerical simulations, which provided insights on the flow around and inside the impacting drop. The results of the drop impact on dry surfaces indicate that the splashing scenario depends strongly on the physical properties of the liquids and not on the surrounding gas or the kinematic impact conditions. It was also demonstrated that the mechanism of gas entrapment at the early stage of the impact is not responsible for the splashing of drops; however, the physical properties of the surrounding gas influenced the spreading lamella and the ejection of secondary droplets. The results demonstrated that the prompt splash is indeed well described by the Rayleigh-Taylor instability in the spreading lamella. The drop impact on wetted surfaces always generates a chaotic and thin corona, which bends and deforms itself during the entire splashing process. Contrary to the splashing on dry surfaces, the break-up of the corona can be attributed to at least three different instabilities: rim-bending, Rayleigh-Taylor, and Rayleigh-Plateau instabilities. Those instabilities generate a host of small secondary droplets in a wide range of sizes and velocities. It was found that the thin ejected corona leads to hole formation and the eventual detachment from its base at the last stage of impact. The thickness of the corona was also estimated using two different theoretical methods. The outcome of high-speed impact on dry and wetted surfaces were quantified in this thesis. The results of the theoretical, experimental, and numerical analyses were combined to describe completely the formation of the secondary droplets. The presented methods allow the prediction of the splashing phenomenon for a drop impacting dry or wetted surfaces at low and high speed.In dieser Studie wurde der Aufprall von Flüssigkeitstropfen bei hohen Geschwindigkeiten auf glatte trockene und benetzte Oberflächen mit experimentellen und numerischen Methoden untersucht. Dafür wurde ein Schwungrad-Experiment entwickelt, mit dem der Tropfenaufprall mit verschiedenen Durchmessern, Aufprallgeschwindigkeiten, Flüssigkeiten und Gasgemischen analysiert werden konnte. Ausgewählte experimentelle Fälle wurden durch numerische Simulationen ergänzt, welche einen tieferen Einblick in die Strömung um und innerhalb des aufprallenden Tropfens ermöglichten. Die Ergebnisse des Tropfenaufpralls auf trockenen Oberflächen deuten darauf hin, dass das Zerspritzen-Szenario stark von den physikalischen Eigenschaften der Flüssigkeiten und nicht von dem umgebenden Gas oder den kinematischen Aufprallbedingungen abhängt. Außerdem konnte nachgewiesen werden, dass der Mechanismus des Gaseinschlusses in der frühen Phase des Aufpralls nicht für das Zerspritzen der Tropfen verantwortlich ist. Jedoch haben die physikalischen Eigenschaften des umgebenden Gases einen Einfluss auf die Entstehung von Sekundärtropfen. Mittels einer theoretischen Analyse konnte bewiesen werden, dass das Prompt-Zerspritzen durch die Rayleigh-Taylor-Instabilität in der Flüssigkeitslamelle beschrieben werden kann. Der Tropfenaufprall auf benetzte Oberflächen erzeugt immer eine Korona, die sich während des gesamten Zerspritzenvorgangs verbiegt und verformt. Im Gegensatz zum Zerspritzen auf trockene Oberflächen kann der Zerfall der Korona auf mindestens drei verschiedene Instabilitäten zurückgeführt werden: Biege-, Rayleigh-Taylor- und Rayleigh-Plateau-Instabilitäten. Diese Instabilitäten erzeugen viele Sekundärtropfen in einem weiten Bereich von Größen und Geschwindigkeiten. Es konnte festgestellt werden, dass die ausbreitende Korona in der letzten Phase des Aufpralls zur Lochbildung und Ablösung führt. Anhang zweier theoretischer Methoden konnte die Dicke der Korona abgeschätzt werden. Im Rahmen dieser Arbeit wurden die Sekundärtropfen beim Tropfenaufprall auf trockene und benetzte Oberflächen quantifiziert. Die Ergebnisse aus den theoretischen, experimentellen und numerischen Analysen konnten vereint werden, um die Entstehung der Sekundärtropfen vollständig zu beschreiben. Die vorgestellten Methoden ermöglichen die Vorhersage des Zerspritzen-Phänomens für einen Tropfen, der mit niedriger und hoher Geschwindigkeit auf trockene oder benetzte Oberfläche aufprallt

A Search for Exotic Higgs Decays or: How I Learned to Stop Worrying and Love Long-lived Particles

A novel search for exotic decays of the Higgs boson to pairs of long-lived neutral particles, each decaying to a bottom quark pair, is performed using 139 fb-1 of sqrt{s} = 13 TeV proton-proton collision data collected with the ATLAS detector at the LHC. Events consistent with the production of a Higgs boson in association with a leptonically-decaying Z boson are analyzed. Long-lived particle (LLP) decays are reconstructed from inner detector tracks as displaced vertices with high mass and track multiplicity relative to Standard Model processes. The analysis selection requires the presence of at least two displaced vertices, effectively suppressing Standard Model backgrounds. The residual background contribution is estimated using a data driven technique. No excess over Standard Model predictions is observed, therefore upper limits are set on the branching ratio of the Higgs boson to LLPs. Branching ratios of 10% are excluded for LLP mean proper lifetimes as small as 4 mm and as large as 110 mm. For LLP masses below 40 GeV, these results represent the most stringent constraint in this lifetime regime

Dear Anybody

ABSTRACT DEAR ANYBODY by Peter Burzynski The University of Wisconsin-Milwaukee, 2018 Under the Supervision of Professor Mauricio Kilwein Guevara Dear Anybody is a dissertation addressed to an anybody, a somebody, and maybe with luck, a nobody. Where its content ends my context begins, but neither truly begin or end, simply intertwine. Anybody can read my dissertation manuscript and understand the poems, but somebody with more knowledge of Eastern Europe’s historical, linguistic, artistic, and poetic contexts will, with hope, find even more joy in all its darkness. It is an Eastern European tradition to find joy in darkness. It is one that arose out of necessity and in turn flourished as a kind of mindset. This mindset comes through in the psyche of the inhabitants of the Late Cold War period, particularly those living in the United States, the Soviet Union, and its Satellite Nations. This national proclivity towards dark humour, semi-Patriotic egoism, and messianic cynicism is only matched by the gregariousness and joy of welcoming strangers, laughter, and soulfulness. Before I delve into the historical context I will also mention that this essay will also attempt to offer the reader cultural, artistic, poetic, and linguistic contexts while performing its main task of giving historical context. Like the book and these contexts, these are all inseparable

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Book Review - Journalism Next: A Practical Guide to Digital Reporting and Publishing

The Internet challenges journalists and journalism schools to keep abreast of technologies deployed to deliver the news. Feeding growing, voracious online news operations requires both traditional skills, plus the ability to deliver news quickly via smart phones, netbooks, and other devices using an assortment of software and online services. Mark Briggs’ new book, Journalism Next, brings together the fragmented resources available all across the Web, neatly tying the technology to what journalists do: gathering and reporting the news